A patient requires a high dose of a new antihypertensive medication because the new medication has a significant first-pass effect. What does this mean?

Correct Answer: C

Rationale: A significant first-pass effect means that a large portion of the medication is metabolized by the liver (and sometimes the gut) before it reaches systemic circulation. This reduces the bioavailability of the drug, requiring a higher oral dose to achieve a therapeutic effect. Choice C accurately describes this process. Choice A is incorrect because the first-pass effect occurs before systemic circulation, not after multiple passes. Choice B relates to renal excretion, not first-pass metabolism. Choice D is a misinterpretation of the term.

Correct Answer: C

Rationale: Tylenol is a brand name for acetaminophen, which is available as a less expensive generic form. The nurse would inform the patient of this cost-effective option.

Correct Answer: D

Rationale: Body surface area (BSA) provides the most accurate calculation for pediatric drug dosages, accounting for size and metabolism differences.

Correct Answer: B

Rationale: Providing a written list of drug names and times enhances safety and adherence, especially for older adults with potential memory issues.

Correct Answer: C

Rationale: The ventrogluteal site is preferred for IM injections in adults due to its safety, minimal nerve presence, and good muscle mass.